Postpartum Belly Issues: Symptoms and When to Seek Help

Postpartum abdominal issues?

Two days after a natural delivery, I noticed a balloon-like bulge just above my navel (about the size of a five-dollar coin).
The nurse and doctor both advised me to wait until after my confinement period to see an internist for an X-ray.
This is my third pregnancy, and I did not experience this with my previous two.
Now, I am forty days postpartum, and my abdomen often feels uncomfortable, similar to having an upset stomach.
The bulge appears and disappears; when it is present, pressing on it causes pain, but when it is not bulging, I cannot locate it.
(Could it be air? Which specialist should I see?) Additionally, my lochia decreased around twenty-seven days postpartum but had a foul odor, and it did not completely stop until thirty days.
On the thirty-sixth day, it returned, resembling the flow of the third day of menstruation (I am thirty-eight days postpartum) and has shown signs of decreasing (I have been breastfeeding a little).
Is this menstruation or lochia? Is it related to the bulge?

A Wei, 20~29 year old female. Ask Date: 2008/10/29

Dr. Chen Changfu reply Obstetrics and Gynecology

Slight bleeding in the late postpartum period is lochia resulting from the healing process of the placental implantation site in the endometrium, not menstruation following ovulation.
Most cases do not require treatment and will improve naturally.
A balloon-like protrusion above the navel is likely due to the pregnancy process, where the enlarged uterus stretches the abdominal wall, causing a decrease in tension of the fascia at the navel area.
Therefore, when abdominal pressure increases, it can lead to a balloon-like protrusion at the site of weaker abdominal wall tension.

Reply Date: 2008/10/29

More Info

Postpartum belly issues can be concerning for many new mothers, especially when symptoms arise that differ from previous experiences. In your case, the presence of a bulge above the navel, described as balloon-like, along with persistent abdominal discomfort, and changes in lochia (the vaginal discharge following childbirth) warrant careful consideration and evaluation.

Firstly, the bulge you are experiencing could be indicative of several conditions. One possibility is a diastasis recti, which is the separation of the abdominal muscles that can occur during pregnancy. This condition can lead to a noticeable bulge, especially when pressure is applied to the abdomen. Another potential cause could be an umbilical hernia, which occurs when tissue protrudes through a weak spot in the abdominal muscles. Given that you mentioned the bulge is sometimes painful, this could suggest that it is not merely gas or air but rather a more significant issue that requires medical attention.

Regarding the abdominal pain that feels like indigestion, it is essential to monitor the severity and frequency of this discomfort. If it is persistent or worsening, it is advisable to consult a healthcare provider. The pain could be related to gastrointestinal issues, such as constipation or gas, which are common postpartum due to hormonal changes and the physical stress of childbirth. However, it could also indicate complications such as an infection or an issue related to the surgical site if you had a cesarean delivery.

As for the lochia, it is normal for the discharge to change in color and consistency over time. Initially, lochia is bright red and may contain small clots. As the days progress, it typically transitions to a pinkish-brown and eventually to a yellowish-white discharge. However, the presence of a foul odor, especially if it is accompanied by increased bleeding or pain, can be a sign of infection, such as endometritis, which is an infection of the uterine lining. The fact that you experienced a return of lochia after it had decreased could also be concerning and should be evaluated by a healthcare professional.

Given these symptoms, it is crucial to seek medical attention. You should consult with your obstetrician or a healthcare provider specializing in postpartum care. They may perform a physical examination and possibly imaging studies, such as an ultrasound, to assess the bulge and any underlying issues. If there is a concern for infection or other complications, they may also conduct laboratory tests.

In summary, while some postpartum symptoms can be normal, the combination of a painful bulge, persistent abdominal discomfort, and changes in lochia, particularly with an unpleasant odor, should not be ignored. It is essential to communicate your symptoms clearly to your healthcare provider, who can guide you through the appropriate evaluations and treatments. Remember, your health and well-being are paramount, and seeking help is a crucial step in your recovery journey.

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